Understanding & Managing - CARI

1 Understanding & ManagingSexualised Behaviour in Children & Adolescentsguidelines for parents & carersBy Kieran McGrath CARI A5 Cover_Layout 1 27/10/2010 13:42 Page 1 About the McGrathholds a degree in Law and a Masters in Social Work fromUniversity College Dublin. Between 1981 and 1987 he worked as a Social Workerand Social Work Manager with the Eastern Health Board (now HSE). From 1988until 2002 he worked as Principal Social Worker and later Assistant Director in StClare s Child Sexual Abuse Assessment & Treatment Unit, Children s UniversityHospital, Temple St, Dublin. He is also an accredited trainer of the Primary,Secondary and Tertiary Prevention of Sexually Abusive Behaviours in Childhoodand Adolescence course, developed by Gail Ryan of the Kempe Childrens Centre,Department of Paediatrics, University of Colorado School of Medicine, Denver,Colorado. Since January 2006 he has been working works independently as aChild Welfare Consultant in both Ireland and Spain.

2 Email: Kieran McGrath, 2010 The CARI Foundation, 2010 CARI A5 Cover_Layout 1 27/10/2010 13:42 Page 2 Page 1 Guidelines for Parents & CarersPrefaceBy Mary Flaherty, CEO, CARI FOUNDATIONCARI is pleased to be involved in the production of this booklet offering a wide range ofinterested parties advice on how to evaluate and respond to sexualised behaviour inchildren and young people. Formerly such behaviour was found only in the aftermath ofsexual abuse but in recent years it is increasingly evident in cases where there is nosuspicion of such abuse. CARI has postulated that it is the increasing sexualisation ofsociety, through the internet, on TV and across the media generally that may be part ofthis. Over the past decade ever increasing numbers of parents, teachers and carers havecontacted our services looking for advice about how to cope with various levels ofsexualised play and other harmful activities observed in even very young booklet aims to give clear information and guidance to all who need it.

3 Initially itprovides a very useful and clear outline of behaviours which may be encountered rangingfrom those normally expected to those causing gravest concern. The colour coding ofbehaviours makes this very accessible. It provides a shared language for discussion withchildren and those involved in intervening to manage and hopefully correct leaflet has been enriched by its author Kieran McGrath s depth of knowledge and frontline experience of dealing with these issues over many years. In his years in the St Clare sUnit in the Children s University Hospital, Temple Street, Dublin which assesses allegationsof sexual abuse and provides therapy to abused children, he was able to identify a rangeof sexualised behaviours and to develop a model of working to manage, reduce andeliminate such behaviour. This knowledge can now be applied in the s collaboration with Kieran has allowed us to pool our experiences of working withchildren and their families and carers or teachers to respond effectively to this behaviourwhich unchecked can spread through a family, group or class very quickly indeed.

4 For society there remains questions of where the, so called, Sexual Revolution has takenus and what strange fruit it can yield. One of these questions is how can we moderate thenegative impacts on children from being exposed to an increasingly consumerist, soft-pornographic approach to sexuality from very early years? This booklet is a smallcontribution to dealing the fall out from that reality. We are confident that this booklet will be welcomed widely in the all areas of child welfareand child protection and provide a practical tool that will be of support to parents, foster-carers, youth leaders, residential care staff and A5 Guidelines Body_Layout 1 27/10/2010 13:43 Page 1 Page 2 The CARI FoundationContentsPreface Mary Flaherty, CEO, CARI1 Introduction3 Definitions6 Function or Meaning of Behaviour9 When can Behaviour be Classified as Abusive?10 Range of Sexual Behaviour of Children (0-12 Years)12 Range of Sexual Behaviour of Adolescents (13-18 Years)13 Responding to Inappropriate Sexual Behaviours14 Managing Sexualised Behaviour16 Issues of Consent17 Special Contexts - Foster Care and Residential Care20 Concluding Comments22 Further Reading22 Who Can Help23 CARI A5 Guidelines Body_Layout 1 27/10/2010 13:43 Page 2 Page 3 Guidelines for Parents & CarersIntroductionCaring for children will never be easy.

5 In the modern era the threat of sexual abuse hascaused anxiety for both parents and carers in ways that were not foreseen in the public awareness about sexual abuse is now at a very high level - compared to therather na ve approach of the past - there are new developments that still warrant greaterpublic scrutiny than they have received heretofore. One of these areas is the question ofsexualised behaviour in children and adolescents. What makes this issue so complex isthat sexualised behaviour ranges from the perfectly normal and healthy behaviour thatall young people need to experience, to the potentially harmful and destructive behavioursthat can put children at risk. This booklet is designed to give parents and carers information that can guide them whendealing with this, potentially, very tricky issue. The approach is at all times to beproportional to the situation and the individual needs of children and young people. It isalso mindful that the old expression an ounce of prevention is worth a pound of cure isvery apt in this particular area.

6 Intervening quickly and proportionately can prevent a muchmore serious problem from developing later. Sometimes inappropriate sexualisedbehaviour may be an indication that a child is being abused by someone else. At othertimes there may be an emotional problem behind a particular type of behaviour whichneeds to be addressed. Either way it should not be reader will note that the use of the word inappropriate in the last paragraph whichraises one of the key questions in this area: which is normal sexualised behaviour andhow can one define what is or is not appropriate? Part of the challenge is to have accessto a way of defining which is which. Not everyone is as clear as they should be about this challenge is a key objective of this parents constitute the key target group of this booklet, the writer is also mindful ofthe fact that there are over 5000 children in the care of the Health Service Executive (HSE)in the Republic of Ireland. Their foster carers and social care staff can face major challengesin coming to grips with sexualised behaviour among youngsters in care, as many of themcome from circumstances where abuse and neglect of different kinds may leave themvulnerable to developing inappropriate sexualised behaviour.

7 Similarly, there arethousands of children in cr ches and day-care centres in Ireland whose carers havequestions about different behaviours from time-to-time. Likewise, many other professionals- like family doctors - are asked for advice on issues of this sort and, at times, are unsurewhat is the best course of action to follow. It is hoped that this booklet may also be ofassistance to is sexualised behaviour such an important social issue today?No so very long ago the notion of child sexual abuse was one that was shocking to mostpeople. It is only since the late 1980s and early 1990s that Irish society took on board theCARI A5 Guidelines Body_Layout 1 27/10/2010 13:43 Page 3 Page 4 The CARI Foundationfact that sexual abuse of children was a very real phenomenon. This led to a major rise inthe amount of cases of suspected sexual abuse being referred to the child protectionservices operated by the HSE in different parts of the country. This number rose from amere 88 for the entire country in 1984, to over 1000 by 1989.

8 A few years later thenumbers had more than doubled. As a system was found to deal with these cases the profile of the cases being presentedchanged and, more and more, they involved concerns of sexualised behaviour by included children who had themselves been abused and were acting out. It alsoincluded children who had other problems that were manifesting themselves in this also included some who were exposed to inappropriate TV programmes oradult/pornographic videos/DVDs which adversely affected their behaviour. Likewise, therewere some who were exposed to inappropriate adult sexual behaviour, which was notdirected at them but which, nonetheless, had a negative impact on of these cases resulted in very serious fall-out for all concerned. This was partlyinfluenced by the huge media attention that is now given to any form of behaviour thatmight be in any way connected to sexual abuse and the high level of stigma that goeswith it. For example, the writer is aware of instances where families had to move housedue to conflict over sexualised behaviour between neighbouring children.

9 This hasoccurred in diverse neighbourhoods: from areas traditionally associated with socialproblems to leafy, middle-class , the value of intervening sensitively but, at the same time, minimally, can tbe overemphasised. The old adage that it is not necessary to take a sledge-hammer tocrack a nut is appropriate in this context. The most one needs to crack a nut is a author has seen children emotionally crushed through insensitive handling of minorcases of inappropriate sexual behaviour. On the other hand he is also aware that, for fartoo long, behaviour of this kind was ignored and allowed to grow into something muchmore problematic. The aim of this booklet is to aid parents, carers and professionals infinding a balance with this sensitive A5 Guidelines Body_Layout 1 27/10/2010 13:43 Page 4 Page 5 Guidelines for Parents & THAT ARISE FOR PARENTS, CARERS and PROFESSIONALS. If we are honest we have to accept that issues connected with sexuality can presentchallenges for us all.

10 This includes the fact that we may not like to think of children asbeing connected in any way with sexuality. This is one of the first things we have to dealwith as, in the past, it was one of the things that placed obstacles in the way of dealingwith this issue. Many people felt at a loss as to know how to approach it or even whatwords to use in talking to children or even professionals. This was also true forprofessionals who were very unsure of their ground. They weren t sure, for example, aboutwhat was considered normal , what constituted sexual experimentation and how todecide the meaning of consent .Although the capacity for sexual arousal is inborn, the way in which people behavesexually is actually learnt. Society s denial of sexuality includes denial of both normal anddeviant sexual behaviour prior to adolescence. Early intervention in sexually abusivebehaviour is the best prevention because of the physiological rewards attached to sexualbehaviour.